How does this medication work? What will it do for me?

Pregabalin belongs to the class of medication known as analgesics. It is used to relieve neuropathic pain associated with diabetic peripheral neuropathy (pain from damaged nerves due to diabetes) and postherpetic neuralgia (persisting pain following healing of the rash due to shingles).

Pregabalin is also used to relieve pain associated with fibromyalgia (pain in the muscles, ligaments and tendons). It is also useful in managing central neuropathic pain (pain from damaged nerves of the brain and spinal cord).

Pain from damaged nerves may feel sharp, burning, tingling, shooting, or numb. It is not known exactly how pregabalin works, but it is thought to work in the brain to decrease the release of chemicals responsible for pain. For some people, improvement in pain may occur as early as the first week of treatment with pregabalin.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

To treat neuropathic pain associated with diabetic neuropathy and post herpetic neuralgia, the recommended adult starting dose of pregabalin is 150 mg per day, given in 2 or 3 divided doses (e.g., 75 mg twice a day or 50 mg 3 times a day).

To treat neuropathic pain associated with the central nervous system, the recommended adult starting dose of pregabalin is 150 mg per day, given in 2 divided doses (e.g., 75 mg twice a day).

To treat pain associated with fibromyalgia, the recommended adult starting dose of pregabalin is 150 mg per day, given in 2 or 3 divided doses (e.g., 75 mg twice a day or 50 mg 3 times a day ).

After one week of treatment, your doctor may increase the dose of pregabalin to 300 mg per day, given in 2 divided doses (e.g., 150 mg twice a day). The maximum recommended daily dose of pregabalin is 600 mg.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Pregabalin may be taken with food or on an empty stomach.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose of this medication by a few hours, take it as soon as possible and continue your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature in the original packaging and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Pregabalin should not be taken by anyone who is allergic to pregabalin or to any of the ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

constipation

dizziness

drowsiness or sleepiness

dry mouth

forgetfulness

lack of energy

trouble concentrating

weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

unexplained muscle pain, tenderness, or weakness (especially if accompanied by fever or a general feeling of being unwell)

Stop taking the medication and seek immediate medical attention if any of the following occur:

seizures

signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort

symptoms of an allergic reaction (shortness of breath or difficulty breathing; hives; swelling of the eyes, mouth, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

September 17, 2019

Health Canada has issued new restrictions concerning the use of pregabalin. To read the full Health Canada Advisory, visit Health Canada's web site at healthycanadians.gc.ca.

Allergic reaction: Some people have developed a serious allergic reaction called angioedema to this medication. Symptoms include swelling of the face, mouth (lips, gums, tongue), neck, throat, and upper airway. If these occur, seek immediate medical attention.

Central nervous system (CNS) depressants: Taking CNS depressants such as opiates (e.g., morphine, codeine) and benzodiazepines (e.g., diazepam, lorazepam) or alcohol while taking pregabalin could result in excessive sleepiness or drowsiness and even coma. Talk to your doctor if you are taking these medications.

Drowsiness/reduced alertness: Pregabalin may cause dizziness and drowsiness. Do not engage in activities requiring mental alertness, such as driving or operating machinery, until you know how this medication affects you.

Drinking alcohol while you are taking pregabalin may make these effects more pronounced. It is strongly recommended that you avoid drinking alcohol while you are taking pregabalin.

Heart problems: Pregabalin may cause fluid to build up in the body. If the fluid accumulates around the lungs or heart, symptoms of heart failure may become worse. If you have heart failure or other heart problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any signs of heart problems getting worse, such as difficulty breathing, rapid weight gain or chest pain to your doctor immediately.

Kidney function: Pregabalin is primarily eliminated from the body by the kidneys. Kidney disease or decreased kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregabalin may reduce kidney function and can cause kidney failure. If you notice any signs of your kidneys not working well, such as decreased amounts of urine being produced, swelling of the legs and ankles, difficulty urinating, or an increased need to urinate at night, contact your doctor as soon as possible.

Male fertility: Animal studies have shown the use of pregabalin to be associated with decreased fertility, sperm abnormalities, and birth defects. It is not known if these effects would happen in people. If you plan to father a child, discuss using this medication with your doctor first.

Muscle pain: If you experience muscle pain, tenderness, or weakness with or without fever, contact your doctor immediately.

Skin problems: Pregabalin may cause skin ulcers or sores. Pay extra attention to your skin while taking this medication, especially if you have diabetes. If you notice any new skin sores or skin problems let your doctor know.

Stopping this medication: Stopping pregabalin suddenly may result in withdrawal symptoms such as insomnia, nausea, headache, diarrhea and seizures. If it is necessary to stop taking this medication, talk to your doctor about the best way to reduce your dose before stopping your medication.

Suicidal behaviour: People taking this medication may feel that they may want to hurt themselves or others. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Weight gain: Pregabalin may cause weight gain and swelling of the extremities. Report any significant weight gain or any swelling of the legs, arms, or other areas of the body to your doctor.

Pregnancy: Information about the safety and effectiveness of using pregabalin during pregnancy is limited. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking pregabalin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children and adolescents less than 18 years of age.

Seniors: The effectiveness of the kidneys in removing pregabalin from the body tends to decrease with age. Seniors may need lower doses of this medication to reduce the possibility for side effects.

What other drugs could interact with this medication?

There may be an interaction between pregabalin and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.